General physiotherapy instructions after ACL reconstruction surgery For a successful outcome of surgery, rehabilitation exercises are of utmost importance. These have to be started from the day following your surgery and are gradually modified as your recovery progresses. General instructions Recovery depends on the nature of problem you had and type of procedure performed. Each individual responds differently to surgery Don t compare your recovery with other patients Exercises should be performed without any jerky or abrupt motion Bathing Do not wet the operated area. After stitch removal, you may take bath/ shower freely POST OP DAY 0 1. Do ankle toe pumps exercise after every 2 hours. Remember to bend your ankles up and down
2. R.I.C.E. R Rest I Ice C Compression E - Elevation POST OP DAY 1 1. Keep on repeating the Ankle toe pump exercise ater every 2 hours. 2. Keep on regularly Icing the operated knee Do 10 reps of each of the following exercises twice daily 3. Isometrics Quads Slowly tighten muscles on thigh of straight leg. Try to straighten your knee. Hold for 5 to 10 seconds.
4. Static Hamstring Press the towel below your heel, hold for 5-10 seconds and then relax 5. Assisted Hip Abduction Keep your toes pointed towards ceiling. Move your leg out to the side as far as possible. slowly return to the starting position and relax. 6. Heel Slides Bend knee and pull heel towards buttocks upto 30 degrees 7. Walking with the help of walker strictly only after strapping your knee with knee brace Walk 3-4 times in a day All four legs of the walker should be on the ground before taking a step Take small steps when turning, do not twist on operated leg
POST OP DAY 2 1. Follow same as above exercises twice daily 2. Passive Straight Leg Raise Lift 3. Start using Tripod or quadripod stick for walking for maximum of 4 weeks, Strictly wearing a knee brace ( only if comfortable) 4. Toilet Training Using a regular or raised toilet seat: Back up to the toilet seat until you feel it against the back of your legs Reach back with one hand a time to the edge of the toilet seat Lower yourself by bending your good leg
5. Chair Sitting Toilet transfer using a commode chair is just like using a regular armchair FOLLOW THE SAME FOR A WEEK AND FROM 2 ND WEEK 1. Continue same exercises 2. VMO exercises
AFTER 4 WEEKS 1. Continue same exercises as advised 2. Start using Hinge Brace and use it for next 3 months 3. Wall Slides 4. Single step up and down 5. Stair climbing/descending (Go with Good/Come with Bad) 6.
7. Standing exercises 8. Cycling RETURN TO WORK 1. Sedentry office work can be resumed in 6 weeks 2. If in sales or one that involves touring, you may take 12 weeks to return to the job 3. Use hinge brace regularly for 6 weeks
6 WEEKS AND ABOVE (RESISITIVE EXERCISES) Tie a light, ½kg to 1kg initialy weight cuff around ankle and do 1. Leg extensions without straightening the knee completely in sitting 2. Straight leg lift 3. Leg press against wall 4. Back curl in standing 5. Can resume gym for upper limb 6. Leg press 7. Other exercises like cycling with resistance, swimming can be gradually resumed and sports participation can be started once you have regained strength and range of motion in operted leg